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NATURE OF THE PROBLEM l Primary concern is for the safety of the patient n Drugs must be prepared aseptically n Contamination can be fatal to the patient l Secondary concern is the safety of the healthcare worker n Exposure to hazardous drugs must be kept as low as possible n Many opportunities for exposure

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WORKER PROTECTION l Horizontal cabinets should not be used for hazardous drug preparation l Class II or Class III BSCs (+/-) must be used l Vented BSCs recommended l Leur-lock, needle-less and closed systems should be used for preparation and administration

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OCCUPATIONAL MONITORING l AIR SAMPLING n Air sampling often does not detect drugs or detects low levels of drugs n May be due to technical problems – Glass fiber or paper filter materials – Drugs in vapor phase

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OCCUPATIONAL MONITORING l URINE ANALYSIS FOR SELECTED DRUGS n Most studies have been performed in Europe n In 18 studies, all but two studies detected drugs in the urine n In four studies, drugs were found in the urine of workers who were not handling them